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is one report of lower neurodevelopmental scores in

preterm infants (n = 103; <31 weeks’ gestational age)

associated with repeated doses of sucrose for analgesia

(39). The safe maximum dose of sucrose is unknown.

I. Contraindications

1. There are no absolute contraindications to using analgesia and/or sedation when deemed clinically appropriate.

2. Be aware of the potential side effects associated with the

specific agent selected and take the proper precautions.

References

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of Pediatrics: Prevention and Management of Pain in the Neonate:

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2. Anand KJS. Clinical importance of pain and stress in preterm

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in neonates. Arch Pediatr Adolesc Med. 2003;157:1058.

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42 Section I ■ Preparation and Support

16. Bjorkman S. Prediction of drug disposition in infants and children

by means of physiologically based pharmacokinetic (PBPK) modeling: theophylline and midazolam as model drugs. Br J Clin

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18. Stevens BJ, Pillai RR, Oberlander TE, et al. Assessment of pain in

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2007:67.

19. Hummel P, Puchalski M, Creech SD, et al. Clinical reliability

and validity of the N-PASS: neonatal pain, agitation and sedation

scale with prolonged pain. J Perinatol. 2008;28:55.

20. Johnston CC, Stevens BJ, Yang F, et al. Differential response to

pain by very premature infants. Pain. 1995;61:471.

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in preterm neonates who require ventilatory support: results of the

NOPAIN trial. Neonatal Outcome and Prolonged Analgesia In

Neonates. Arch Pediatr Adolesc Med. 1999;153:331.

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27. Cote CJ, Notterman DA, Karl HW, et al. Adverse sedation events

in pediatrics: a critical incident analysis of contributing factors.

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28. Morriss FG, Abramowitz PW, Nelson PS, et al. Risk of adverse

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29. Barrett DA, Barker DP, Rutter N, et al. Morphine, morphine-6-

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30. Bhat R, Abu-Harb M, Chari G, et al. Morphine metabolism in

acutely ill preterm newborn infants. J Pediatr. 1992;120:795.

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Pharmacol. 2005;59:691.

32. Shah PS, Shah VS. Propofol for procedural sedation/anaesthesia

in neonates. Cochrane Database Syst Rev. 2011;(3): CD007248.

33. Chana SK, Anand KJS. Can we use methadone for analgesia in

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34. Jacqz-Aigrain E, Burtin P. Clinical pharmacokinetics of sedatives

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35. Frank LS, Vilardi J, Durand D, et al. Opioid withdrawal in neonates after continuous infusions of morphine or fentanyl during

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36. Lambert GH, Muraskas J, Anderson CL, et al. Direct hyperbilirubinemia associated with chloral hydrate administration in the

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37. Reimche LD, Sankaran K, Hindmarsh KW, et al. Chloral hydrate

sedation in neonates and infants—clinical and pharmacologic

considerations. Dev Pharmacol Ther. 1989;12:57.

38. Mayers DJ, Hindmarsh KW, Sankaran K, et al. Chloral hydrate

disposition following single-dose administration to critically ill

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39. Johnston CC, Filinon F, Snider L, et al. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks

postconceptual age. Pediatrics. 2002;110:523.


43

7 Temperature Monitoring

8 Cardiorespiratory Monitoring

9 Blood Pressure Monitoring

10 Continuous Blood Gas Monitoring

11 End-Tidal Carbon Dioxide Monitoring

12 Transcutaneous Bilirubin Monitoring

II Physiologic

Monitoring


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